Using mini-arthrotomy for dorsal plating to treat intraarticular distal radius fractures: can it improve radiological and clinical outcomes?
| Autor: | Annika Müller, Florin Allemann, Florian Hess, Christopher Child, Philipe Sebastian Breiding, Hans-Christoph Pape |
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| Přispěvatelé: | University of Zurich, Hess, Florian |
| Rok vydání: | 2020 |
| Předmět: |
musculoskeletal diseases
Dorsum Wrist Joint medicine.medical_specialty Sports medicine medicine.medical_treatment 610 Medicine & health Wrist Critical Care and Intensive Care Medicine 03 medical and health sciences Fracture Fixation Internal 2732 Orthopedics and Sports Medicine 0302 clinical medicine Dash medicine Humans Orthopedics and Sports Medicine Range of Motion Articular Arthrotomy 030222 orthopedics business.industry Chronic pain 030208 emergency & critical care medicine medicine.disease 2746 Surgery Surgery 10021 Department of Trauma Surgery medicine.anatomical_structure Treatment Outcome Radiological weapon Emergency Medicine 2711 Emergency Medicine 2706 Critical Care and Intensive Care Medicine business Range of motion Radius Fractures Bone Plates |
| Zdroj: | European journal of trauma and emergency surgery : official publication of the European Trauma Society. 47(6) |
| ISSN: | 1863-9941 |
| Popis: | Using palmar plating to treat complex intraarticular distal radius fractures is standard of care. However, fracture fragments can also be managed using a dorsal approach with arthrotomy, which is useful when treating fractures involving the dorsal joint aspect. We compared radiological and clinical outcomes after dorsal plating with or without an intraoperative arthrotomy. 31 of the 359 patients with a distal radius fracture had an AO Type 2R3 C3 fracture surgically treated using a dorsal approach (01/2015–10/2018). Fractures other than C3 were excluded from this analysis. Group 1 (n = 14) had no arthrotomy, Group 2 (n = 17) underwent intraoperative dorsal mini-arthrotomy. Clinical results were measured by range of motion (ROM), Patient-rated wrist evaluation (PRWE) and Disabilities of arm, shoulder and hand (DASH) scores. Radiological results were evaluated using the AO scoring system. ROM, DASH and PRWE did not differ significantly between groups. Joint surface restoration was insufficient in five patients in Group 1 (p = 0.05). A trend towards better radiological results, although not statistically significant, was noted in Group 2 (p = 0.06). Plate removal was performed in 12 patients due to limited ROM (6 patients in each group). One patient (Group 2) with chronic pain and step off in the joint line underwent corrective osteotomy. We did not detect a difference in patient outcomes using the dorsal longitudinal mini-arthrotomy; however, it may prevent incongruent joint reconstruction since all cases occurred in Group 1. In the absence of intraoperative CT scan, longitudinal mini-arthrotomy may be used to enhance visualization and achieve joint surface reconstruction. |
| Databáze: | OpenAIRE |
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